Jamaica
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Gov’t urged to set up halfway houses for the mentally ill

Merline McIntosh is once again living in fear in her home. Her 48-year-old schizophrenic son, who was admitted at the Kingston Public Hospital (KPH), has been discharged into her care, despite her public outcry against the move.

Four months ago, The Gleaner reported on how her son, who has been battling the mental illness for 30 years, spent most of his life in and out of mental institutions and on medication since, with his mother as his primary caregiver.

He was admitted to KPH after his involvement in a machete-swinging altercation with a neighbour where he also locked his mother out of her house.

Although she said he has not had an episode since he turned up at her gate two weeks ago, she is still anxious that it will happen at any moment, and, at 90 years old, she said she will not be able to cope.

“He knocked on my door, and when I answer and looked out, it was him. Mi nuh expecting him, mi nuh know what is happening to him, so mi was so scared,” she said.

She said her unease was compounded because she was not made aware of his discharge. And her unease has been forcing her to sleep elsewhere.

There is no specific protocol that governs the discharge of a mental health patient, acting CEO at KPH Dr Natalie Whiley told The Gleaner.

INFIRMARIES NOT EQUIPPED

She outlined that the hospital’s decision to discharge a patient is a clinical one that depends on the status of the patient. But she emphasised that it is a very meticulous process.

“Upon review by the consultant who has responsibility for care of that patient, a decision is taken to discharge the patient and there is a discharge process which would involve, among other things, patient education, referral to outpatient facility that may continue the patient’s care, discharge orders relating to medication, and other additional investigation that need to be done,” she said.

But forensic psychiatric expert, Dr Myo Kyaw Oo, wants the Government to establish more halfway houses to accommodate cases like McIntosh’s son.

“The Government of Jamaica doesn’t have halfway houses, supervised facilities for mentally ill,” he stated. “We should have some type of infirmaries ... halfway houses, supervised living facilities for discharged mentally ill who are crippled by the illness. But they are not to be treated as inpatient, they are to be treated as residents in those facilities.”

He contends that infirmaries are often not equipped to handle the needs of the mentally ill, and can be reluctant to take in such patients.

“To handle mentally ill, it is not like street people you put in the infirmary. They need a special set of staff and they need supervision, they need to be back up by the psychiatrist, mental health team, medication, a bigger programme,” he said.

Two months ago, Minister of Health and Wellness Dr Christopher Tufton announced a $150-million transformation of the Bellevue Hospital in Kingston. This will involve creating a mental rehabilitation centre to cater to the more than 400 social cases that are currently housed there. And a mental health hospital for the care and treatment of acute mental health patients.

NOT ENOUGH

Oo is not convinced this will be enough.

“A policy decision will have to be made, in the future, whether this facility will serve the entire population of Jamaica,” he said.

Meanwhile, Dr Kevin Goulbourne, director of mental health and substance use at the Ministry of Health & Wellness, said the Government is still working out the final details around the remodelling of Bellevue Hospital.

“To transform Bellevue from what it is into what we want it to be, there’s some other paperwork and things to be worked out because the fact that it was a particular institution and we’re going to transform it ... There are processes that you have to go through that involve Cabinet and so on,” he said.

Adding that is it the ministry’s intention to have similiar rehabilitation facilities across the island.

But McIntosh, in the meantime, said she feels abandoned.

“The problem is mine and not theirs, therefore they don’t care, so I just have to go on and ask the Lord to help me,” she said.

sashana.small@gleanerjm.com